Psoriasis.
Psoriasis.
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DOI：
10.1038/nrdp.2016.82
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发表时间：
2016-11-24
期刊：
影响因子：
--
通讯作者：
Gottlieb, Alice B
中科院分区：
文献类型：
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作者：
Greb, Jacqueline E;Goldminz, Ari M;Gottlieb, Alice B
银屑病是一种慢性、免疫介导的疾病，具有皮肤和全身表现，对患者的生活质量有实质性的负面影响。虽然多基因遗传，但Psoblastoma有很强的遗传基础。虽然银屑病的可解释的遗传效应的大约一半映射到主要组织相容性复合体，但是已经鉴定了>70个其他基因座，其中许多涉及核因子-κ B、干扰素信号传导和IL-23-IL-23受体轴。银屑病病理生理学的特征在于真皮和表皮中的异常角质形成细胞增殖和免疫细胞浸润，涉及先天性和适应性免疫系统，其中树突状细胞和T细胞等细胞具有重要作用。常见的合并症是风湿性和心血管性的，特别是银屑病关节炎。目前银屑病的治疗方法包括外用药物、光疗法、传统的全身药物和生物制剂。治疗可以联合使用或作为单一疗法。靶向特定疾病介质的生物疗法已成为治疗中度至重度疾病的主要手段，而治疗轻度至中度疾病的进展有限。
Psoriasis is a chronic, immune-mediated disorder with cutaneous and systemic manifestations and substantial negative effects on patient quality of life. Psoriasis has a strong, albeit polygenic, genetic basis. Whereas approximately half of the accountable genetic effect of psoriasis maps to the major histocompatibility complex, >70 other loci have been identified, many of which implicate nuclear factor-kappaB, interferon signalling and the IL-23-IL-23 receptor axis. Psoriasis pathophysiology is characterized by abnormal keratinocyte proliferation and immune cell infiltration in the dermis and epidermis involving the innate and adaptive immune systems, with important roles for dendritic cells and T cells, among other cells. Frequent comorbidities are rheumatological and cardiovascular in nature, in particular, psoriatic arthritis. Current treatments for psoriasis include topical agents, photo-based therapies, traditional systemic drugs and biologic agents. Treatments can be used in combination or as monotherapy. Biologic therapies that target specific disease mediators have become a mainstay in the treatment of moderate-to-severe disease, whereas advances in the treatment of mild-to-moderate disease have been limited.